KELI S GRISETA Advanced Practice Nurse License verification

Business Entity

ACTIVE

License Type

Advanced Practice Nurse

Description

ADV PRACTICE NURSE CONTROL SUB

License Number

30*****76

License Status

ACTIVE

Business

First Name

KELI

Middle

Last Name

GRISETA

Business Name

KELI S GRISETA

Original Issue Date

03/20/2020

Effective Date

05/20/2024

Expiration Date

05/31/2026

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/02/2026